Surgical correction of tetralogy of Fallot with previous systemic to pulmonary artery shunts

Fifty-four patients with previous Blalock (32) and Potts (22) systemic artery-pulmonary artery shunts and subsequent total correction for tetralogy of Fallot are reported. A separate posterolateral approach was employed to obliterate the Potts shunt. There were seven operative deaths and two late deaths. Infundibular stenosis with a normal pulmonary valve gave the best results. In comparison with our concomitant series without a shunt, the presence of a Blalock or Potts anastomosis did not affect the over-all result. Postoperative bleeding was a major complication, requiring reoperation in seven. An excellent result with probable cure was obtained in 30, and there was good improvement in ten of the 54 patients.